Experience Of Loss Research Articles

Reconstructing a Meaningful Self: The Identity Work of People Living With Chronic Disease.

With the escalating number of people diagnosed with chronic disease globally, research aimed at supporting their adjustment and coping is invaluable. Reconstructing a sense of self is core to the psychosocial adjustment of people with chronic disease (PwCD), and meaning making is central to their coping with the diagnosis. Despite the growing number of PwCD living productive lives, their identity work is underexplored. This article reports on an in-depth multiple case study that explored the identity work of PwCD from a meaning-making perspective. Data were gathered from three cases using semi-structured interviews, document analysis, and diaries. Data analysis entailed interpretative phenomenological analysis and flexible pattern matching. Three themes describe participants' identity work process: First, they narrate a broken identity, having experienced identity disruption, discontinuity, and loss; second, they envision an ideal identity through existential reflection; and third, they reconstruct a meaningful identity. Reconciling the broken self with an ideal self leads to the construction of a meaningful self. The meaningful self is conceptualized in participants' application of Frankl's meaning-making principles, as they constructed a purposeful self (creative), a connected self (experiential), and a determined self (attitudinal). The article discusses the implications for helping professionals and organizations in supporting PwCD as they work toward rebuilding a meaningful self, facilitating their identity work in the search of a meaningful self.

Redesigning the Hospital Environment to Improve Restfulness

Hospital wards are often not conducive to patient sleep, negatively affecting patient health and experience. To assess determinants of in-hospital restfulness and to design and test rest-promoting interventions on the wards in partnership with clinicians, staff, and patients. This rapid-sequential mixed-methods quality improvement study was performed at a large urban academic hospital in St Louis, Missouri, from May 1, 2021, to December 31, 2022, with follow-up through hospitalization. Mixed-methods activities involved purposively selected hospitalized adults on the wards, nurses, hospitalists, and hospital staff. Interventions included all adult hospitalizations on the study wards. Sequential stacked bundles of multimodal rest-promoting interventions (general education, focused education on light or noise, safely reducing overnight monitoring or testing, and environmental personalization). Pre-post comparisons of perceived nighttime quietness (via surveys) and sleep opportunity (coprimary outcomes) as well as clinical interruptions overnight, environmental noise, and adoption and satisfaction. Nine patients (4 female) and 14 staff members (10 female; 3 nurse managers or administrators, 10 nurses, and 1 physician) were interviewed, 38 surveys were collected, and more than 100 hours of observation were performed. Interventions were evaluated for 671 patients (mean [SD] age, 60 [16] years; 336 [50%] female). Determinants of in-hospital rest included infrastructure, staff attitudes, priorities, culture, and patient experiences of anxiety, uncertainty, and loss of control. Informed by these determinants, codesign workshops yielded 39 potential interventions, from which 9 were selected for testing. Related interventions were organized into bundles, which were tested in sequential 2-week sprints. Perceived nighttime quietness improved nonsignificantly during the project (wards "always" quiet at night: 51% preintervention vs 86% postintervention; P = .09), with excessive noise events decreasing from 0.65 (95% CI, 0.53-0.77) to 0 per 100 patient-nights before the intervention (P = .02). Sleep opportunity improved significantly (mean, 4.94 [95% CI, 4.82-5.06] hours per patient-night before the intervention vs 5.10 [95% CI, 5.00-5.20] hours per patient-night after the intervention; P = .01). In this quality improvement study, a set of feasible, acceptable, and beneficial rest-promoting interventions were developed. After implementation of these interventions on the wards, a significant improvement in nighttime quietness and sleep opportunity was observed. These results demonstrate how human-centered design methods can generate practical and effective strategies for improving an important patient-related outcome and a core element of patient experience.

Experiences of individuals receiving "Not Parent Expected" results through direct-to-consumer genetic testing.

As direct-to-consumer genetic testing (DTC-GT) grows in popularity, the unanticipated "Not Parent Expected" (NPE) result has become more prevalent. An NPE result is the discovery that one parent, often the father, is not a biological parent. This study explores the impact of making an NPE discovery through DTC-GT. Twenty-five participants were interviewed and transcripts were analyzed using thematic analysis. NPE discovery had an impact on participants' personal identity. They frequently reported having experienced grief and loss among other emotions whether the discovery confirmed a participant's prior suspicions or was unexpected. Strained parent/child relationships prior to the NPE discovery and further negative impact on the relationship after DTC-GC were common themes. Connection to newly identified biological parents and family was a common goal reported by many participants, with mixed outcomes of such connections. Further research will assist in deepening our understanding and confirming the findings of this study.

Holistic Nursing Care for Perinatal Loss Based on Swanson's Theory of Caring.

The purpose of this study was to inform perinatal loss care by expanding upon the five processes of Swanson's Theory of Caring through a holistic lens. This study was a qualitative content analysis of 34 interview transcripts of parents' experiences with perinatal loss. A priori codes were identified using a holistic model which guided the integration of parents' holistic needs into Swanson's Theory. Nurses can address parents' physical, psychological, social, spiritual, and cultural needs using Swanson's Theory to provide high-quality, holistic care that may foster healing. Parents were appreciative of nurses who were transparent, did not avoid talking about their baby, facilitated memorialization, and fostered bonding. Anticipating parents' needs, being emotionally present, and recognizing the meaning of the perinatal loss experienced helped parents to have a more positive loss experience. By incorporating holistic interventions into care guided by Swanson's Theory, nurses can empower parents within their loss experience. Interventions to create memories, foster bonding and connection, promote autonomy, and celebrate personhood may facilitate healing. It is necessary to ensure nurses have the support and resources to attend to parents' holistic needs, including education and sufficient time for care interactions. Providing education in perinatal loss and grief, particularly to new nurse graduates, is necessary to ensure nurses are equipped to provide holistic care to families experiencing perinatal loss.

Stories of Bereavement: Examining Medical Students' Reflections on Loss and Grief.

In this qualitative study, we used thematic analysis to examine reflective essay data from students at a United States public medical school (N = 60). We sought to identify how students describe their experiences of loss and grief, as well as examine differences between students' responses to personal and professional loss. Students in both groups reported similar reactions with some expected differences: Students who experienced professional loss more often emphasized skills focused on helping patients' families. In accounts of personal loss, students appeared more focused on their own grief and helplessness. Students in both groups noted many positive as well as negative reactions. Students recounting both types of loss reported little about how they coped with grief or about receiving either informal or institutional support. Medical educators should help students develop effective coping skills in response to loss and provide better institutional support during times of bereavement.

Development of the First Patient-Reported Experience Measure (PREM) for Hearing Loss in Audiology Care-My Hearing PREM.

Patient-reported experience measures (PREMs) provide important insights into the challenges experienced when living with a chronic condition. Although patient-reported outcome measures (PROMs) exist in audiology, there are no validated PREMs to help clinicians understand patient perspectives and identify areas where patients may need additional support or interventions. The aim of this study was to develop and evaluate content for the new 'My Hearing PREM', which captures lived experiences of hearing loss from patients' perspectives. My Hearing PREM was developed and tested in two key phases. Phase 1 involved generating the PREM prototype in accordance with our conceptual model of the lived experience of hearing loss. In Phase 2, cognitive interviews were conducted with adults with hearing loss to appraise the content of the PREM (relevance, clarity, acceptability and comprehensiveness) and assess its respondent burden. Key stakeholders (e.g., adults with hearing loss, patient and public representatives, clinicians and researchers) were consulted throughout Phases 1 and 2 to review and refine the PREM. Interview data were analysed using thematic analysis. Sixteen participants (aged 16 years and over) with hearing loss took part in cognitive interviews, recruited from UK audiology departments and non-clinical settings (e.g., lip-reading classes, national charity links and social media). Most PREM items were found to be relevant, clear, acceptable and comprehensive. Several problems were identified, including items not working well with the response scale options, irrelevant questions and a lack of clarity about terms (e.g., healthcare professionals) and whether questions should be answered based on the use of hearing aids (or not). The PREM was amended accordingly. Currently, no hearing loss-specific PREMs exist in audiology. Involving multiple stakeholders in the development of the PREM helped to ensure that the items were relevant, clear, acceptable and comprehensive. The PREM is undergoing further evaluation and refinement in preparation for investigating the feasibility of implementing it into clinical practice. Ongoing Patient and Public Involvement and Engagement (PPIE) with key groups (South Asian Women's groups, young people's groups, learning disability networks and student populations) was integral to the study. PPIE members reviewed patient information sheets and consent forms, advised on recruitment, reviewed the interview schedule and checked coding and analysis procedures. PPIE members provided feedback on the PREM's comprehensibility. Members of the public, including adults attending lip-reading classes and hearing aid users from the South Asian community, provided feedback on iterative PREM drafts.

Lost and changed meaning in life of people with Long Covid: a qualitative study

ABSTRACTLong Covid (LC) has been called the greatest mass-disabling event in human history. For patients, LC not only has implications for quality of life but also for meaning in life: how one’s life and the world are understood and what is seen as valuable in one’s life. This qualitative empirical study used a Constructivist Grounded Theory approach to investigate the meaning in life of people struggling with LC through ten patient interviews. This study shows that patients lose their prior understanding of life and come to a changed meaning in life, in part due to the experienced (social) isolation and loss of (both physical and cognitive) abilities caused by LC. Moreover, patients struggled with acceptance, uncertainty, and the inherent incomprehensibility and uncontrollability that living with LC entails, though this simultaneously co-existed with hope, optimism and acceptance. Additionally, dimensions of meaning intersect; a patient having some understanding of their illness (dimension of meaning: comprehension) required an understanding Other (dimension of meaning: connection). Emerging from lockdown brought the challenge and isolation of adjusting to chronic illness in society as usual (albeit divided about COVID-19 measures). This study thus offers novel insights regarding changed, present, and sought meaning in life for LC patients.

The Narrativist Turn in Healthcare and its Implications on the Experience of Perinatal Grief

The non-recognition of perinatal bereavement in society leads parents to an isolated condition that may hinder their psychological adjustment after the loss (Layne; Markin and Zilcha-Mano). Improving bereaved parents’ experiences of communication in healthcare practice thus seems to be crucial to lessening the risk of dysfunctional grief. This paper presents a research project on the topic of perinatal death, “Words Fail Me”: Naming the Unnamable (PERINAT), funded by the French National Agency for Research (2023-2027). By focusing on the metaphorical constructions used by bereaved parents in their narratives of perinatal death, PERINAT seeks to improve the communication experience of the bereaved by furthering health care practitioners’ understanding of this grief. The study is conducted by means of a dataset collected in 2022-23 from interviews with a hundred bereaved parents in France. The preliminary findings of this ongoing project are meant to be used to inform and improve the support offered by health care providers who are likely to come across a bereaved parent in their professional capacity. More specifically, from a perspective of narrative medicine, this contribution seeks to explore what the study of metaphor can potentially offer to the development of narrative competence in the training of health professionals. By developing higher awareness of bereaved parents’ narrative, more specifically of their use of figurative language, practitioners can make sense of parents’ needs and emotional responses to their experience of loss in order to ease it. As Norwood (122) has it, metaphor, like poetry, “can make unknown known and the unspeakable speakable”. This is also in line with the most recent promotion of a relationship-centered and patient-centred notion of care (Bensing; Pluut).

Seller Responsibilities in Digital Transactions on the Shopee Marketplace System at the Trendy You Outfit Store

The huge potential in the electronic commerce (e-commerce) business cannot be separated from the development of internet users and the growth of the internet in Indonesia. The forms and interactions of e-commerce business actors in Indonesia are divided into various types, Shopee is a type of Online Marketplace Provider (OMP) e-commerce, apart from the profits that can be obtained from online shopping, there are also risks that may occur when the wrong goods are sent by the wrong party. seller and delays in delivery of goods. This research was conducted on one of the Shopee marketplaces, namely the Trendy You Outfit store, whether the responsibilities implemented by the Shopee marketplace have been implemented by the Trendy You Outfit store. The aim of this thesis research is first, how to carry out Shopee's marketplace responsibilities. second, how to resolve disputes at the trendy you outfit shop. The type of research is sociological legal research, namely research carried out on actual conditions or real conditions that occur in society. This research uses primary data originating from field data and secondary data consisting of primary, secondary and tertiary legal materials. The data collection technique used in this research is using unstructured interview methods and literature review. This research uses qualitative methods, namely research procedures that produce descriptive data, namely what is stated in writing. The research results show that the implementation of responsibilities at the Trendy You Outfit store in the Shopee marketplace has not yet been implemented. As a consumer, in accordance with the provisions of law number 8 of 1999 concerning consumer protection, article 4 letters b and h, the right to receive compensation, compensation and/or replacement is explained if the goods and/or services received are not in accordance with the agreement or are not as they should be. There needs to be legal protection, both preventive and repressive, for consumers if the seller's responsibilities to consumers are not fulfilled. And experienced losses from the consumer side and losses from sellers which had the impact of reducing interest in purchasing goods.

A longitudinal examination of contributors to new parents’ perception of their infant

ABSTRACT Background Previous studies have examined contributors to personal growth (PG) following the birth of the first child. This study examines for the first time the role of PG as a potential mediator in the relationship between individual characteristics (bond with parents and experiences of parental loss) and parental perception of their infant (warmth, invasiveness). By focusing on PG, this study offers a novel perspective on how parental experiences and relationships influence early parent-child dynamics over time. Methods We used data from a longitudinal study among new Israeli parents. Participants completed self-report questionnaires in three phases: Up to one year following the birth of their first child (n = 2,182); Six months later (n = 1,045); and after another six months (n = 811). Results The study revealed associations between background variables and perceived infant’s warmth and invasiveness over time. A cross-lag panel model revealed that parental care as reported in Phase 1 was linked to perceived warmth in Phase 1, whereas parental overprotection and parental loss, both reported in Phase 1 were linked to perceived invasiveness in Phase 1. PG mediated the association between parental care and perceived warmth over time. Conclusions This study sheds light on the significance of parental bond, experiences of parental loss, and personal growth in shaping parents’ perception of their infants. The findings highlight the importance of targeted support programmes to promote positive parent-infant relationships, emphasising the need for further longitudinal research to understand the dynamics of these relationships over time.

Evaluation of acaricide treatments to experimentally reduce winter tick load on moose

AbstractQuantifying the consequences of winter ticks (Dermacentor albipictus) on the body condition and life‐history traits of moose (Alces alces) is a challenge due to several confounding factors. We experimentally reduced tick load on moose calves by testing the effectiveness of 2 acaricide treatments: one using topical permethrin (5%) alone and the other a combination of a more concentrated topical permethrin (44%) and orally administered fluralaner (25 mg/kg). We evaluated changes in tick load, body mass, hematocrit, and hair loss severity and occurrence, from recaptured or resighted moose calves over winter in Québec and New Brunswick, Canada. Nearly all untreated moose (94%, n = 41) experienced hair loss compared to calves that received the combination of permethrin (44%) and fluralaner (41%, n = 37). Of treated moose that exhibited hair loss, only 22% had more than 5% damage and some already had hair loss at capture. Capturing moose later likely increased the probability of observing hair loss when resighting treated moose, although hair loss essentially remained lower for treated calves than for untreated calves. In untreated moose, tick load at capture tended to drive hair loss, but calendar date mostly drove hair loss severity, especially during April. There was no clear effect of topical permethrin (5%) on tick load, body mass, and hematocrit. Body condition simply decreased from January captures to spring recaptures, regardless of treatment. Our results suggested that combining permethrin (44%) and fluralaner effectively reduced tick load based on hair loss severity and occurrence. We cannot, however, disentangle the individual effects of permethrin (44%) and fluralaner. We discuss research implications and considerations of using such a treatment for reducing winter tick load.

Tooth-loss related masticatory and aesthetic experiences among middle-aged and older adult Danes.

To determine whether tooth loss relates to patient experiences of masticatory or aesthetic problems and is a useful measure of oral health and treatment needs and to compare experiences of tooth loss among middle-aged and older Danes. Cross sectional online- and telephone interview questionnaire study. 1,060 Danish citizens aged 40 years or older. Experiences of difficulties eating/enjoying food or smiling/showing of teeth due to tooth related problems within the last 6 months. Data analysis used tests of proportions and ordinal logistic regression. Half the participants had a full or almost full dentition. Among those with tooth loss, 21-44% reported difficulties eating/enjoying food. In ordinal logistic regression, difficulties eating were associated with being younger, having fewer teeth and having visibly missing teeth. Being unwilling to smile or show one's teeth was associated with being younger, having fewer teeth, having lower socioeconomic position and having visibly missing teeth. Wearing a prosthesis did not ameliorate eating difficulties or unwillingness to smile. Tooth loss is a meaningful measure of oral health but cannot stand alone. Many adults with even substantial tooth loss did not experience functional or aesthetic problems. Tooth loss is associated with negative masticatory and aesthetic experiences among middle-aged than older adults. Removable prostheses were not associated with better functional or esthetic outcomes.

Exploring lived experiences with tooth loss among fully edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda

BackgroundOne of the most prevalent oral health issues affecting mankind is tooth loss. Besides extractions due to periodontal disease and caries, accidents and lack of dental knowledge can also result in tooth loss. Nevertheless, no known published studies have examined how edentulous patients in Uganda have lived with tooth loss. The objective of the present study was to investigate experiences of tooth loss among Ugandan edentulous patients attending Makerere University Dental Hospital.MethodsThis was a cross-sectional qualitative study using purposive recruitment of respondents. A total of 15 respondents were chosen from a variety of socio-economic groups. Qualitative data were collected using oral interviews in form of note taking and an audio-recorder. The data collected comprised the causes of tooth loss, the physical and psychological effects of losing teeth, the difficulties in managing oral hygiene when one is toothless, coping mechanisms, and supportive interventions after losing natural teeth. The collected data were transcribed and analyzed thematically using a software, Atlas Ti. The generated qualitative data were summarized as text, while demographic characteristics were presented in a table.ResultsOral infections such as periodontal disease (which destroy tooth supporting tissues), tooth decay and trauma from accidents were reportedly the main causes of tooth loss. In case of tooth pain as a first symptom, most patients choose self-medication with over-the-counter drugs and home remedies. They only consult dental professionals when the condition deteriorates. Tooth loss was associated with problems of eating, facial aesthetics and low self-esteem.ConclusionThe present study found that tooth loss was caused by periodontal disease, tooth decay and trauma from accidents. Loss of teeth was escalated by poor health seeking behavior. Tooth loss resulted in pain, eating difficulties, speech difficulties, poor facial appearance and consequently low self-esteem.

‘Life outside the diamond is a wrench’: on experiencing talent loss in sports

ABSTRACT Many elite athletes find the loss of their athletic abilities due to age or injury to be a profoundly challenging experience. While talent development is a well-studied phenomenon, far less attention has been paid to the issue of talent loss. We address this gap by exploring the experience and challenges faced by elite athletes who are losing, or who have lost, their talent. Drawing on three different understandings of the nature of talent, we argue that the experience of talent loss is constituted by three distinct yet interrelated forms of disorientation. We conclude by examining how athletes and those supporting them may respond to these challenges.

Exploring Identity in Poetry: Love, Loss, and Belonging in Sylvia Plath and Elizabeth Bishop through the Lens of Social Identity Theory

This study leverages Social Identity Theory (SIT) to explore themes of identity, belonging, and relationships in Sylvia Plath's "Mad Girl's Love Song" and Elizabeth Bishop's "One Art." Using a comparative qualitative approach, the research examines how personal and social identities influence the speakers' experiences of love and loss. Plath's poem illustrates a crisis of social identity marked by the speaker's detachment and internal conflict, reflecting struggles with isolation and idealization. In contrast, Bishop portrays loss as a communal experience, highlighting an evolving identity characterized by resilience and acceptance. The findings reveal that while both poets illustrate identity transformations shaped by relationships and loss, they utilize different coping mechanisms—Plath through fantasy and Bishop through pragmatic acceptance. This analysis underscores the intricate relationship between social identity and emotional responses, enhancing our understanding of how societal contexts impact individual identity formation.

"Nobody Knew . . . What Was Gonna Happen": Indigenous Loss and Grief During the COVID-19 Pandemic.

Indigenous peoples have experienced higher rates of loss and death compared to the general population, partly due to historical loss. This qualitative inquiry focused on understanding Indigenous women's experiences of loss, grief, and death during the COVID-19 pandemic, involving 31 head-of-household Native American women from a southeastern US tribe. Reconstructive analysis of data from a community-based critical ethnography identified the following themes spanning the ecological levels of the FHORT: (a) loss of finances, (b) loss of structure and loss of self, (c) death due to COVID-19, (d) disrupted mourning and burial rituals, and (e) grief and extensive losses. Results indicate that the pandemic not only exacerbated historical loss, but interventions and models for working through grief and loss should not only be culturally tailored and promote healing across all ecological domains and include physical, mental, emotional, and spiritual aspects, but should also address historical trauma, collectivist values, and traditional ways.

Self vs. Other in Affective Forecasting: The Role of Psychological Distance and Decision from Experience.

This work tests self-other differences in the impact bias using the perspectives of psychological distance and decision from description vs. experience. Two studies compared the bias participants made for themselves and for others in a sequential gambling task. The task involved two identical gambles where the first gamble was mandatory and participants made decisions (accept or reject) for the second gamble. Planned decisions were made anticipating a gain or loss in the first gamble, and revised decisions were made following the actual experience of gain or loss. Study 1 compared decisions for self, abstract other, and a close friend. Study 2 replicated the comparison between the self and a close friend and added a measure of empathy. Both studies demonstrated an impact bias indicating that participants tended to overestimate the impact of anticipated outcomes on their tendency towards risk. Specifically, revised decisions indicated risk-aversion shifts after experienced gain and risk-seeking shifts after experienced loss. A reversed pattern emerged for close friends, indicating risky shifts after gain and cautious shifts after loss in Study 1 and for highly empathetic participants in Study 2. Assessing the utility functions that underlie participants' decisions revealed a qualitative difference. The utility function for the self was consistent with prospect theory (with moderate intensity and diminishing sensitivity), while the utility function for others was more intense with little or no diminishing sensitivity. This research offers new insights regarding the roles of psychological distance and description vs. experience in affective forecasting and impact bias for self vs. other.

The study of tertiary irrigation channel in Pulau Gambar irrigation cannals for increase rice productivity

Abstract Tertiary Irrigation Channel used to experienced significant water loss. The lack of water would caused rice productivity decreased. This study is intended to evaluate the efficiency of tertiary irrigation channels in Pulau Gambar Irrigation Cannals and create a simulation and adjustment of combination channel design to optimize the efficiency. The result of the study shown the efficiency of first channel is 65.37%, the second channel efficiency is 60.25%, and the third channel is 64.87%. The flow velocity average is less than critical flow velocity would caused sedimentation in channel base that it needs to adjust the channel design to optimize the channel efficiency. The most optimize channel design for first channel by channel width (B) 0.35 m and channel depth (D) 0.18 m, the second channel got optimize design by channel width (B) 0.31 m and channel depth (D) 0.15 m, and the third channel got optimize design by channel width (B) 0.37 m and channel depth (D) 0.20

Psychoanalytic Observations Near the End of Life

ABSTRACT Using psychoanalytic free association, introspection, self-analysis, and his more than 50 years of experience as an adult and child psychoanalyst, the author explores the limited psychoanalytic literature on the individual analyst’s personal reactions to death and dying. Then he describes his experiences of loss of function, diminished psychoanalytic identity, and his personal attitudes toward death and an afterlife.

026. Utilizing Pre-Existing Lacerations for Frontal Bone Fracture Management: A Case Report

Background: Patients with fractures of the frontal bone use the coronal incision approach to expose the anterior cranial vault, including the forehead. The flap allows for widespread exposure of the fractures, facilitating access for the removal of segmental fractures and hematoma evacuation. Maintaining sufficient pedicle width is crucial to reduce the risk of unintentional arterial damage and to ensure proper venous drainage. The objective of this study was to document the surgical approach for segmental fracture removal under a forehead pedicle flap. Case: This case presents a 22-year-old male with moderate traumatic brain injury, who had two lacerations on his forehead and showed an open depressed fracture of the frontal bone after a motor vehicle collision. The patient experienced loss of consciousness and a history of vomiting. Imaging revealed intracerebral hemorrhage in the frontal region and a depressed fracture of the frontal bone. Intraoperative findings revealed the fracture site through the previous laceration incision. The fracture was clearly evaluated by the surgeon using tools to lift the skin between the two incisions. Conclusion: Despite the access for segment fracture removal being conducted through a pre-existing laceration, the patient outcomes were favorable, and no complications were reported.